title: Borderline personality disorder and chronic pain: a practical approach to evaluation and treatment.
abstract: Patients with chronic pain present a spectrum of complexity that can be overwhelming for the individual practitioner. These patients require thoughtful care and a comprehensive treatment plan. This complexity should be acknowledged, not avoided, and the patient should be engaged, not shunned. A practical approach will assist in developing expertise and proceeding empathically. The presence of a superimposed personality disorder significantly increases the difficulty of caring for these patients. Studies investigating the prevalence of borderline personality disorder in patients with chronic pain averaged 30 %, highlighting the importance of being able to effectively treat this patient population. Appropriate management of these patients should focus on a collaboration to practice productive behaviors despite intense emotional distress. Longitudinal research provides a foundation for an optimistic prognosis that can be enhanced with this rehabilitative approach.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Johns Hopkins Medicine, Osler 320, 600 North Wolfe Street, Baltimore, MD 21287-5371, USA.
authors.forename: Vicki
authors.initials: V
authors.lastname: Kalira
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Treisman
authors.forename: Michael R
authors.initials: MR
authors.lastname: Clark
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D058443:Catastrophization; D059350:Chronic Pain / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010347:Patient Care Planning; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011379:Prognosis; D016728:Self-Injurious Behavior / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D001569:Benzodiazepines